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Hepatitis C: Should I Take Antiviral Medicine?

Guides you through the decision to take antiviral drugs for hepatitis C. Covers treatment with peginterferon and ribavirin. Lists side effects. Includes interactive tool to help you make your decision.

Hepatitis C: Should I Take Antiviral Medicine?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

People with chronic hepatitis C may not need to decide about treatment right away. Your doctor can monitor the infection to see if it is causing liver damage or other problems.

The medicines used to treat hepatitis C can have serious side effects that make people feel so sick that they stop taking them. Some medicines are more likely than others to cause problems. The kind of medicines you take to treat hepatitis C depend on the genotype of the virus you are infected with and how serious the infection is.

Hepatitis C is a virus that infects the liver. You can
get hepatitis C when you share needles to inject illegal drugs with someone who
has the virus. You can also get it by having a shot, tattoo, or piercing with a
needle that has infected blood on it.

When most people get
hepatitis C, they don't even know they have it. Early symptoms are mild and
don't last long.

Some people who get the virus have it for a short
time and then get better. This is called acute hepatitis C. But up to 85 people
out of 100 who are infected with the virus get long-term (chronic) hepatitis
C.1 "Chronic" means that the virus is active in your
body for more than 6 months.

Chronic hepatitis C can cause
swelling and tiny scars to form in your liver. When this happens, your liver
doesn't work well. About 25 out of 100 people who have chronic hepatitis C get
more serious liver problems such as
cirrhosis, liver cancer, or liver failure. This most
often happens over a period of 20 years or more.2 If
the damage is severe, you may need a liver transplant.

A
combination of antiviral medicines is the main treatment for hepatitis C.
When used together,
peginterferon and ribavirin can stop or slow the
growth of the virus. A protease inhibitor (such as boceprevir, simeprevir, or telaprevir) or a nucleotide analog inhibitor (such as sofosbuvir) also may be used to increase effectiveness.

Treatment
usually is needed for at least 12 weeks. But it may continue for up to a year depending on the genotype of the virus and how serious the infection is.

Results from your blood tests can help you and your doctor
decide if you should start treatment. Your doctor may also take a tiny piece of
your liver, called a
biopsy, to see if it has been affected by the
virus.

The medicines used in the past to treat hepatitis C did not always work well, especially for infection with genotype 1. But new medicines are available, and they work much better and have fewer side effects. So people who may not have been helped by medicines in the past are being treated successfully now.

Even though hepatitis C is serious, most people can
manage the infection and lead active lives. Two key steps are to take good care
of yourself and get regular checkups to watch for liver problems.

Antiviral
medicines can cure hepatitis C or slow the growth of the virus and help prevent serious
liver problems. There are several types of the hepatitis C virus that cause
infection. Six different
strains (genotypes) of hepatitis C have been found. Most people
in the United States have genotype 1.

Studies have shown
that:

A combination of peginterferon and ribavirin
works for as many as 50 out of 100 people with genotype 1 or 4.3 This means that it doesn't work for the other 50
people.

Adding a protease inhibitor (such as boceprevir, simeprevir, or telaprevir) to peginterferon/ribavirin therapy controls hepatitis C in up to 88 out of 100 people who have genotype 1.4, 5

The peginterferon and ribavirin combination also works for as many as 80 out of 100
people who have genotype 2 or 3.3 This means that
combination therapy doesn't work for 20 out of 100 people who have these
genotypes.

Adding sofosbuvir to peginterferon and ribavirin significantly improved hepatitis C treatment in people who had genotype 1.6 Using sofosbuvir with only ribavirin was effective for people with genotype 2.6

Antiviral medicines may
not decrease the amount of the virus in your blood. But some studies have shown
that treatment may still reduce scarring in your liver. This can lower your
chance of getting cirrhosis and liver cancer.7

A combination of medicines is more likely to
work if you have:

Low levels of the hepatitis C virus in your
blood when you start treatment.

Small amounts of liver damage when
you start treatment.

Treatment may not be an option for everyone who has
hepatitis C. These medicines don't work for everyone, and they cost a lot. Some
insurance companies may cover all or part of the cost of these medicines. If
you don't have health insurance, drug companies may
be able to help cover the cost of your treatment.

What are the side effects of antiviral medicines?

About half of the people who take both peginterferon and ribavirin have
serious side effects during their treatment. Some people may need to
stop taking their medicines because the medicines make them feel very sick.
Talk to your doctor if your hepatitis C medicines are causing serious side
effects.

Personal stories about antiviral treatment for hepatitis C

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

I would
like to try combination treatment with peginterferon and ribavirin to try to
keep my liver healthy. I realize that I may never have liver failure, even if I
don't have treatment, but I want to feel like I've done everything possible to
prevent it.

Frank, age
29

I was shocked when I tried to donate blood
and found out that I had hepatitis C. My liver enzymes have been up, but my
liver doesn't show any signs of damage yet. I'm glad. I hate the thought of
having a treatment that might make me sick, and I really don't believe that my
liver will be damaged. I am just going to keep visiting my doctor to keep an
eye on my condition.

Rick, age 50

I have two teenagers, and I really want to
stay as healthy as I can for as long as I can while they grow up and have their
own families. My doctor says antiviral treatment is the best chance I have of
staying healthy and active, so I am going to take my doctor's advice and have
treatment.

Nina, age
45

The side effects of treatment worry me. It
also costs a lot of money, and it doesn't help everyone. I don't feel sick,
even though my doctor says that my liver enzymes have been a little high for
about the past 8 months and my liver biopsy showed some mild damage. Because of
my concerns, my doctor and I decided to keep checking my liver enzymes and
repeat the liver biopsy in a few years.

Karen, age 53

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antiviral medicine for hepatitis C

Reasons not to take antiviral medicine for hepatitis C

I'm willing to take medicine regularly for at least 12 weeks to help get rid of the virus in my body.

I don't like taking medicine for a long period of time.

More important

Equally important

More important

I'll do whatever I can to avoid getting liver disease or liver cancer.

I'm not worried about getting liver disease or liver cancer.

More important

Equally important

More important

I'm worried that I might spread the virus to others if I don't treat the infection.

I'm not worried about spreading the virus to others.

More important

Equally important

More important

I'm not worried about missing work to go to the doctor for the examinations and tests that I need.

I can't afford to take time off from work to go to the doctor.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Morgan RL, et al. (2013). Eradication of hepatitis C virus infection and the development of
hepatocellular carcinoma: A meta-analysis of observational studies. Annals of Internal Medicine, 158(5, Part 1): 329–337.

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Hepatitis C: Should I Take Antiviral Medicine?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Get the facts

Compare your options

What matters most to you?

Where are you leaning now?

What else do you need to make your decision?

1. Get the Facts

Your options

Take antiviral medicine for hepatitis C.

Don't take antiviral medicine. Have regular blood tests and
maybe a liver
biopsy to check for liver problems.

Key points to remember

Chronic hepatitis C can be treated and sometimes cured with medicines. But treatment is expensive and does not work for everyone.

People with chronic hepatitis C may not need to decide about treatment right away. Your doctor can monitor the infection to see if it is causing liver damage or other problems.

The medicines used to treat hepatitis C can have serious side effects that make people feel so sick that they stop taking them. Some medicines are more likely than others to cause problems. The kind of medicines you take to treat hepatitis C depend on the genotype of the virus you are infected with and how serious the infection is.

FAQs

What is hepatitis C?

Hepatitis C is a virus that infects the liver. You can
get hepatitis C when you share needles to inject illegal drugs with someone who
has the virus. You can also get it by having a shot, tattoo, or piercing with a
needle that has infected blood on it.

When most people get
hepatitis C, they don't even know they have it. Early symptoms are mild and
don't last long.

Some people who get the virus have it for a short
time and then get better. This is called acute hepatitis C. But up to 85 people
out of 100 who are infected with the virus get long-term (chronic) hepatitis
C.1 "Chronic" means that the virus is active in your
body for more than 6 months.

Chronic hepatitis C can cause
swelling and tiny scars to form in your liver. When this happens, your liver
doesn't work well. About 25 out of 100 people who have chronic hepatitis C get
more serious liver problems such as
cirrhosis , liver cancer, or liver failure. This most
often happens over a period of 20 years or more.2 If
the damage is severe, you may need a liver transplant.

What medicines are used to treat hepatitis C?

A
combination of antiviral medicines is the main treatment for hepatitis C.
When used together,
peginterferon and ribavirin can stop or slow the
growth of the virus. A protease inhibitor (such as boceprevir, simeprevir, or telaprevir) or a nucleotide analog inhibitor (such as sofosbuvir) also may be used to increase effectiveness.

Treatment
usually is needed for at least 12 weeks. But it may continue for up to a year depending on the genotype of the virus and how serious the infection is.

Who should take antiviral medicines for hepatitis C?

Results from your blood tests can help you and your doctor
decide if you should start treatment. Your doctor may also take a tiny piece of
your liver, called a
biopsy, to see if it has been affected by the
virus.

The medicines used in the past to treat hepatitis C did not always work well, especially for infection with genotype 1. But new medicines are available, and they work much better and have fewer side effects. So people who may not have been helped by medicines in the past are being treated successfully now.

Even though hepatitis C is serious, most people can
manage the infection and lead active lives. Two key steps are to take good care
of yourself and get regular checkups to watch for liver problems.

How well do antiviral medicines work?

Antiviral
medicines can cure hepatitis C or slow the growth of the virus and help prevent serious
liver problems. There are several types of the hepatitis C virus that cause
infection. Six different
strains (genotypes) of hepatitis C have been found. Most people
in the United States have genotype 1.

Studies have shown
that:

A combination of peginterferon and ribavirin
works for as many as 50 out of 100 people with genotype 1 or 4.3 This means that it doesn't work for the other 50
people.

Adding a protease inhibitor (such as boceprevir, simeprevir, or telaprevir) to peginterferon/ribavirin therapy controls hepatitis C in up to 88 out of 100 people who have genotype 1.4, 5

The peginterferon and ribavirin combination also works for as many as 80 out of 100
people who have genotype 2 or 3.3 This means that
combination therapy doesn't work for 20 out of 100 people who have these
genotypes.

Adding sofosbuvir to peginterferon and ribavirin significantly improved hepatitis C treatment in people who had genotype 1.6 Using sofosbuvir with only ribavirin was effective for people with genotype 2.6

Antiviral medicines may
not decrease the amount of the virus in your blood. But some studies have shown
that treatment may still reduce scarring in your liver. This can lower your
chance of getting cirrhosis and liver cancer.7

A combination of medicines is more likely to
work if you have:

Low levels of the hepatitis C virus in your
blood when you start treatment.

Small amounts of liver damage when
you start treatment.

Treatment may not be an option for everyone who has
hepatitis C. These medicines don't work for everyone, and they cost a lot. Some
insurance companies may cover all or part of the cost of these medicines. If
you don't have health insurance, drug companies may
be able to help cover the cost of your treatment.

What are the side effects of antiviral medicines?

About half of the people who take both peginterferon and ribavirin have
serious side effects during their treatment. Some people may need to
stop taking their medicines because the medicines make them feel very sick.
Talk to your doctor if your hepatitis C medicines are causing serious side
effects.

Why might your doctor recommend antiviral medicines?

You have active infection. This means that
you have high levels of the virus in your blood.

Your liver enzyme
levels are more than twice the normal amount.

You are likely to
develop serious liver disease such as cirrhosis or liver
cancer.

You have mild to severe liver damage.

You have another serious health problem, such as HIV infection.

2. Compare your options

Take antiviral medicine

Don't take antiviral
medicine

What is usually involved?

You take medicine for 12 weeks to a year.

You have regular exams and blood tests to check for liver
problems.

You have
regular exams and blood tests to check for liver problems.

You take
steps to prevent further liver damage by not drinking alcohol or using illegal
drugs.

What are the benefits?

Antiviral
medicines can cure hepatitis C or slow the growth of the hepatitis C virus.

They can help prevent serious liver problems.

You can
avoid the side effects and cost of antiviral medicines.

What are the risks and side effects?

Possible
side effects may include:

Fever and muscle
aches.

Headaches.

Nausea and diarrhea.

Depression.

Hair
loss or skin rash.

Trouble sleeping.

Low
blood cell counts, including anemia.

If
the hepatitis C virus is active in your body, you may:

Get severe liver disease.

Get
liver cancer.

Spread the infection to others.

Personal stories

Are you interested in what others decided to do? Many people have faced this decision. These
personal stories
may help you decide.

Personal stories about antiviral treatment for hepatitis C

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"I would like to try combination treatment with peginterferon and ribavirin to try to keep my liver healthy. I realize that I may never have liver failure, even if I don't have treatment, but I want to feel like I've done everything possible to prevent it."

— Frank, age
29

"I was shocked when I tried to donate blood and found out that I had hepatitis C. My liver enzymes have been up, but my liver doesn't show any signs of damage yet. I'm glad. I hate the thought of having a treatment that might make me sick, and I really don't believe that my liver will be damaged. I am just going to keep visiting my doctor to keep an eye on my condition."

— Rick, age 50

"I have two teenagers, and I really want to stay as healthy as I can for as long as I can while they grow up and have their own families. My doctor says antiviral treatment is the best chance I have of staying healthy and active, so I am going to take my doctor's advice and have treatment."

— Nina, age
45

"The side effects of treatment worry me. It also costs a lot of money, and it doesn't help everyone. I don't feel sick, even though my doctor says that my liver enzymes have been a little high for about the past 8 months and my liver biopsy showed some mild damage. Because of my concerns, my doctor and I decided to keep checking my liver enzymes and repeat the liver biopsy in a few years."

— Karen, age 53

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to take antiviral medicine for hepatitis C

Reasons not to take antiviral medicine for hepatitis C

I'm willing to take medicine regularly for at least 12 weeks to help get rid of the virus in my body.

I don't like taking medicine for a long period of time.

More important

Equally important

More important

I'll do whatever I can to avoid getting liver disease or liver cancer.

I'm not worried about getting liver disease or liver cancer.

More important

Equally important

More important

I'm worried that I might spread the virus to others if I don't treat the infection.

I'm not worried about spreading the virus to others.

More important

Equally important

More important

I'm not worried about missing work to go to the doctor for the examinations and tests that I need.

I can't afford to take time off from work to go to the doctor.

More important

Equally important

More important

My other important reasons:

My other important reasons:

More important

Equally important

More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Morgan RL, et al. (2013). Eradication of hepatitis C virus infection and the development of
hepatocellular carcinoma: A meta-analysis of observational studies. Annals of Internal Medicine, 158(5, Part 1): 329–337.

Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.

Morgan RL, et al. (2013). Eradication of hepatitis C virus infection and the development of
hepatocellular carcinoma: A meta-analysis of observational studies. Annals of Internal Medicine, 158(5, Part 1): 329–337.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use.
How this information was developed to help you make better health decisions.